tv Today in Washington CSPAN July 29, 2009 7:30am-9:00am EDT
being purchased means more revenues for those selling food. i'll talk more about that later but the -- just to feed the excess weight of america is probably about $50 billion a year. childhood obesity is also epidemic and childhood obesity has tripled in just a generation. we know that our genes haven't changed this fast. we know that our preferences have changed that fast. we are hardwired to like sweet and salty food. what has changed is our environment and if we are to make a change in the obesity epidemic we're going to have to change the environment again in order to gain control. obesity affects virtually every body system from the lungs, cardiovascular disease, fatty liver, stroke, cat -- and
various lung cancers so the health implications of obesity are major and this really represents a dramatic change in the nature of society. as depicted in the next slide. [laughter] >> now, thinking about how we can address this epidemic we think about how we address any public health problem or any health problem. a pyramid of interventions can be portrayed. starting with those at the most fundamental level of society which most fundamentally affect health and have the biggest impact and going up to those that have the least impact. at the base of this are socioeconomic factors, poverty, housing, inequality. we know poverty is a powerful
predictor of obesity. and there are lots of very good theories for why that should be and i'm sure that's something that will be discussed in the conference and i think the definitive answer remains to be determined. one step above that are the traditional public health measures that change the context, whether it's fluoridating the water, or removing artificial trans fat from the food supply. one is long-lasting protective actions which is a light touch from the classic system. classic immunization but also things like brief intervention for alcohol use, something that significantly reduces alcohol use long time or a colonoscopy for that. another thing that is difficult to do and all of them are effective and the only measure to address some health problems are clinical interventions that require long-term care such as
treatment of high blood pressure, high cholesterol and diabetes. and at the top of this pyramid, what requires often great effort on an individual basis but may have the smallest impact on the societal basis are counseling and education to --, for example, eat less and exercise more. although many people think of public health as being in the business of exhortation, in fact, the need to exhort people to behave differently is a symptom of the failure of public health to arrange societies such or to promote a societal structure such that the healthy choice is the default value. now, there are examples of winnable battles in public health, things that do change the context for health. these include elimination of artificial trans fat. there are significant health benefits for this and with a phase-in there are no significant problems with supply. there has been no significant
increase in cost or change in taste. and the experience in new york city was that not only was artificial trans fat completely eliminated but in doing so saturated fats were also reduced by 10 to 20% with the introduction of new oils. it's important to have a phase-in period but it's certainly possible. and since new york city undertook that effort more than 50 national chains including many of the large restaurant chains have completely eliminated artificial trans fat from their food supply. this is not likely to do much for obesity. we're not certain of that yet. it is likely to do quite a bit for cardiovascular disease and it's an example of a winnable battle. nobody knew they were eating artificial trans fat and nobody in new york city knows they are not eating trans fat and,
therefore, at much less risk of developing heart disease in the future. salt reduction is a second example of a winnable battle. age-related hypertension may not be inevitable. experience from studies of traditional or preindustrial societies suggests that there is no increase in blood pressure with age in populations which have very low salt intake. there are lots of other factors, obviously, in those societies that may account for this. but our experience that two-thirds of people who are over the age of 65 have hypertension is not normal and a significant contributor to it is our chronic overconsumption of salt. we consume salt at something like ten times the minimum requirement in this country. there is an interaction between calories and salt.
the more calories you consume, the more salt you will consume. and the more salt you'll consume as every bartender knows, the more things you'll try and you don't only drink water and zero calorie beverages, you'll drink things with more calories, so the more calories you'll consume. a 50% reduction in salt in 10 years is feasible and would have significant health benefits experience from the united kingdom that industry with partnership of government is capable of achieving a significant reduction without a loss of sales of industry. it's not easy to be done it can be done and it's important that it be done. i'm going to go through some lessons through the tobacco control experience for obesity prevention and control. and if you look at what has worked in tobacco control, fundamentally, the things that
have moved the needle on prevalence are three, price, exposure and image. however, despite having a very robust evidence base for what works for tobacco control, much more robust than what we have for obesity prevention and control, tobacco remains the leading preventible cause of death nationally and globally. there's a large gap between the existence of proven means of reducing tobacco use and the implementation of these measures. an implementation gap, if you will. and we know that preemptive laws which at a national level prevent state action at a state level prevent local action can be very important in preventing effective progress. we also know that political commitment is the single leading predictor of effective action in tobacco control. what tobacco control leaders
have done is to establish a policy package which outlines a comprehensive approach known as the empower strategy. this includes monitoring for tobacco use prevalence and prevention policies. protecting people from exposure to secondhand smoke. offering help to cut -- to help people quit tobacco use. warning people about the dangers of tobacco. enforcing bans on all advertising promotion and sponsorship and raising taxes on tobacco products. where do we stand globally? well, despite the existence of a well-defined set of interventions, which incidentally are very cost-effective or cost-gaining for government in the case of taxation, less than 5% of the world's population is covered by any one of these strategies. when these were implemented in
new york city, the results were rewarding for 10 years using a three-year ruling average, there was no change in the rate of tobacco use in new york city. after raising taxeses, there was a substantial decline in tobacco use. after implementing smoke-free laws, there was a further decline. and after implementing hard-hitting antitobacco ads, there was a further decline resulting in a citywide rate of 15.8% and a rate in children of 8.5%. that's a reduction of 25 and 50% respectfully. 350,000 fewer adult smokers and more than 100,000 fewer smoking-related deaths in future years. now, i'd like to outline what a policy package to reverse and prevent obesity might look like
using the same set of concepts and really emphasizing that this is an outline of what might be. it is a set of thoughts, hypothesis given the state of the evidence currently, it is not an official position. first is price. decrease the cost of healthy food particularly fruits and vegetables. increase the price of unhealthy foods. exposure, increase exposure to healthy foods, let there be water that's drinkable and attractive everywhere. let there be fruits and vegetables everywhere. and think of junk food as a toxin that needs to be removed at a minimum from all schools, healthcare facilities, and government buildings. and image. restricting ads to children and showing the actual impact of
harmful beverages and foods. going through those one by one, price. what has happened over the last several decades and to my view, this is probably the single most likely explanation for the obesity epidemic. what you see in the middle -- i'm sorry. what you see in the middle is the consumer price index. carbonated drinks, sugars and sweets have gotten less expensive over the fast decades while fresh fruits and vegetables have become relatively more expensive. what that means essentially is that not only has food become cheaper overall but unhealthy food has become cheaper and healthy food has particularly become more expensive. more than 200 years ago adam smith wrote, sugar rum and
tobacco are nowhere necessaries of life which are become objects of almost universal consumption which, therefore, are extremely proper subjects of taxation. [laughter] >> a substantial soda tax would probably be the single most effective way we could reduce obesity. a 10% increase of price of sugared beverages resulted in about an 8% technique in consumption. industry data from one company showed a 12% increase of price led to almost a 15% reduction in consumption. those are price elasticities of around minus 1 for those of you who are familiar with that concept. sugar sweetened beverage is a broad concept. we're not talking about soda. we're talking about a wide variety of products. and as we think about sources of revenue for health reform or other societal needs, at 1 cent an ounce a revenue from a soda
tax would be on the order of 100 to $200 billion over the next 10 years. exposure is the next key intervention. increasing exposure to healthy foods, whether it be through placement of supermarkets or placement within supermarkets, better product arrays at small grocery stores, mobile vendors, farmers markets, the availability of water in particular not mentioned here but of critical importance most likely to have ready availability of free and palatable drinks and finger foods is important because, you know, if you think about the difference between unhealthy foods and healthy foods, one of the differences is that you can pick up on healthy foods a lot more easily than you can pick up healthy foods with the possible exception of carrot sticks and you can't only eat carrot sticks
despite what many in this room may think. [laughter] >> decreasing exposure to unhealthy foods, schools with the standard as a minimum standard. and high schools as being also very important. there are very difficult economic forces at play here. and principals face a devil's dilemma of whether they get revenues for very important programs and incredibly straightened fiscal times or whether they try to have a commercial-free environment for children to learn in through graduation from high school. healthcare facilities, government buildings and publicly form programs. the government buys a lot of food at state, federal and other areas as well. >> food ads to children are extensive and i think when we
look back 20, 30 years from now, 10, 20, 30 years from now, we'll say, what in the world were they thinking? allowing the kind of advertising that occurs today still to exist in the midst of an epic of childhood obesity. and the ads that are on tv and internet today will look as old to us then as the tobacco ads from a generation or two ago look to us now. i show one of those ads here. children continue to be exposed to extensive marketing and promotion. they're unable to distinguish between marketing and news or documentaries. and really there is an inundations for ads for unhealthy foods, more than 7,000 ads for food on tv each year, specifically, for children under 12, the highest proportion of
advertising. 85% of food companies have interactive websites for children promoting branded products. more than two-thirds of food ads seen by children are for candy, snacks, cereal fast food. only 5% are for healthier foods, dairy and juice, juice not being particularly healthy. and none for fruits and vegetables. many ads offer premiums or tie-ins to certain characters. as if that's not controversial enough, counter-advertising on healthy food is a key lesson from tobacco control. counter-advertising works to change the image. and what works, unfortunately, are not positive ads about smoke-free living. those have limited or no impact. ads show the human impact of the product and should never attack the victim. show only the reality of what
the product causes in terms of illness, disability, and death. counter-advertising of unhealthy foods is essentially untested in obesity prevention and control. it is in my personal opinion very likely to be effective. it is certain to be very controversial. will food become the next big tobacco? well, the food industry certainly targets children. $1.6 billion bent on youth advertising. nearly $200 million on marketing and schools, celebrity endorsements, sports images, games and promotions, research that creates or causes doubt where no reasonable doubt exists, strategic partnerships with organizations that can act as spokespeople for the food industry, spokespeople from the academy or other locations who can carry the industry message,
introduction of healthier products. the equivalent of light or low tar cigarette than is low less toxic or whole grain cereal. food unlike tobacco is necessary. significant parts of the food industry have an economic interest in healthier food. and most of the food industry is highly attuned to health concerns and is doing active research on healthier products. they know if they can get healthier stuff that sells, they will win the race. that's very important. although regulatory action may be needed in some areas, voluntary action in many areas is possible. and some voluntary action has occurred already and even if and where regulations are needed, it's critically important to communicate well and work closely with industry to make sure that the actions taken are effective.
so do we have a healthy future? obesity and with it diabetes are getting worse. the human and financial costs are enormous. there is an emerges evidence-base on how to address obesity both from a public health standpoint and from a policy standpoint. i do not think that we can wait for perfect evidence. in fact, i think that the existence of evidence will be facilitated by action with programs which are implemented and then rigorously evaluated. the question i think before us and what we have to weigh as a group as we consider the weight of the nation is whether we as a society are willing to take the actions necessary to reverse the epidemic of obesity. thank you very much. [applause]
>> thank you, dr. friedan, for your remarks. i know you will all understand when i say we are truly blessed at cdc to have such a bold and visionary leader. thank you. [applause] >> our next speaker is dr. jim marks, senior vice president at the robert wood johnson foundation. and as you know, he has been a national leader in public health for more than 25 years. currently, he directs the program activities of the robert wood johnson foundation health group, which includes the foundation's work in childhood obesity, public health, and vulnerable populations. dr. mark served as assistant surgeon general as well as director of cdc's national center for chronic disease prevention and health promotion. during his tenure at cdc, he
developed and applied effective strategies to prevent and detect diseases such as cancer, heart disease, and diabetes. he worked to reduce tobacco use and, in fact, to bring visibility to the nation's understanding of the epidemic of obesity. dr. marks has received numerous awards for his outstanding work including the u.s. public health service distinguished award and he has served on many expert panels devoted to improving the public's health. dr. marks often speaks eloquently of the primacy for prevention in public health. please welcome dr. marks. [applause] >> thanks, janet. and good morning, everyone. i'm really pleased to be here to provide some welcoming remarks on behalf of the robert wood johnson foundation and to help open this important conference. the first of its kind on the critically important issue of
obesity prevention and control. i'm also happy to be here to see so many friends and colleagues and to learn about the work you're doing. but even more, i'm excited because i know that the things that come out of this meeting are important for the nation. as janet said, now is the right time for this meeting and you're the right people to be here. and with our nation's capital in the very near distance, there are so many key decisions that are going to be made there that will help shape the health of our nation so we're also in the right place. tom has covered a lot of the important statistics and some of the very important levers that we need to do as a nation. i want to provide a little context. three years ago, the institute of medicine gave our nation a mixed review in its progress report on childhood obesity. on the one hand the iom said public awareness was high and that an array of local, state and national interventions had been launched to curb the epidemic.
the problems of the iom, and i'm paraphrasing it here was that the interventions were too few. they were too weak and too small, too fragmented and too uncoordinated. now it's 2009, there are signs of progress but we're still far from where we need to be and many of the concerns expressed by the iom three years ago still apply today. let's take a look at what's happened over the last few years. the trust for america's health in the robert wood johnson foundation just released the sixth edition of our report f as in fat how policies are failing in america. this year, we reported that 19 states now have nutritional standards for school lunches and briefcases that are stricter than the current usda standards. only four states could make that claim. no question that 19 is a whole lot better than four but it's not 50.
and while it's great to see the states leading like this, now it's time for federal policy to catch up and maybe even lead again. 28 states now have nutritional standards for the competitive foods that are sold a-la-cart in school cafeterias, vending machines and other school fundraisers. in 2004, only six states had such standards. this suggests we're making progress and having schools become healthier and perhaps healthy places for our children to spend their days. good news. but 22 states have no nutritional standards for competitive foods at all. and that's unconscionable. on the physical activity side, every state now has some form of physical education requirement for schools but local implementation has been very slow. driven largely by concerns about costs and misplaced fears that
spending more time in physical activity might slow academic achievement and there are no penalties for schools not following the policies. not even public reporting of school progress on fitness or weight unlike reading or math scores. in 20 days now require measurement of body mass index or some other form of weight-related assessment for students. that's up in 2004. that's critical. a west virginia survey showed only 5% of parents whose children were obese thought they were. how can we expect parents to help if they don't even know their child has a problem? there's more that i could mention. the new community programs in the stimulus package hopefully will be coming out soon and we and other foundations have been making community focus grants and we will be making more. so there's progress to be sure. but i think we all have to agree still too few communities and
states and often the local implementation of state and federal policy is still too weak or poorly adhered to. as a nation we will need to do more but stronger policies widely applied will lead to changes in calories consumed and expended in activity. and following those changes, we will see the changes in weight and bmi. that's not to say that there isn't reason for hope because there is. recent reports suggest that the rate of the epidemic increase is probably slowing and may be close to being halted. the last report that the child obesity prevalence rates had seemed to stabilize since the first time since the 1970s. unfortunately, in that same study the very high obesity rates for african-american children and mexican-american children appeared to continue to rise. this disparity underscores why we must focus our efforts where the need is the greatest
especially on the south and in lower-incomed communities throughout the nation. but i must also refer to last week's cdc report about very young children from wic and other public programs. in last week's report children from our poorer families showed their first evidence of stabilization in obesity rates with some southern states being those showing favorable changes. very exciting findings. the 2009 f as in fat report also supported the idea that the academic curve might be peaking. between 2000 -- 2007 and the 2008 reports adult obesity rates increased in 37 states. between the 2008 and 2009 reports, increases were noted in only 23 states. [laughter] >> we have also heard encouraging progress in towns like somerville, massachusetts, el paso, texas, and arkansas and west virginia appear to show
halting increase among their youth. if i could use the type of language the federal reserve board has used, i might characterize these developments as green chutes. like the green chutes of economic recovery. but until these glimmers of hope turn into evidence of a clear and sustained downturn, we must presume that the current efforts, though better than they were in the past are still too weak, too few and too small. so the question for us at this conference is what can we do to nurture those green chutes and foster more in more places to help them thrive and grow into a movement powerful enough to reverse this epidemic and put us on a course to returning what our bmi distribution used to be like 20 to 30 years ago. that's where we need to go. part of the answer, i believe, brings us to the last part of iom's assessment that obesity prevention efforts are too fragmented and too
uncoordinated. what we still need today is what the iom called for years ago, leadership and coordination. it means connecting and convening and communicating about the best practices and policies in communities across the nation in spreading the word. for us here today, success will require a coming of age of public health. public health claiming its place. the type of macrolevel policy changes needed and he was right because we all know that the most effective obesity interventions won't take place in a doctor's office or anywhere in the medical care sector. public health will need to lead and influence in new areas far from where it has typically operated outside our own comfort zone. key decisions affecting our children's health and the health of our communities are made in places like school board meetings where education leaders decide whether to start p.e.
programs or serve healthier foods in cafeterias. city councils and state legislators in transportation and city councils decide whether to build crosswalks, sidewalks and bike paths and zoning boards for local officials decide which kinds of businesses to welcome them into their communities and/or make it easier for supermarkets to sell fresh fruits and vegetables to move into poorer neighborhoods. .. the evaluation of
effectiveness. these are tools applied often in the past with great effectiveness in infectious disease prevention. but to be successful in reversing this academic, public health must lead in a way that brought in new organizations and players to get leaders from these other places to join in on this issue. everyone from a to z has a role to play in the obesity academic reversal. on the federal side, where are no agencies that start with x, y, or z, the list goes from a to w. the white house. in states that might be the state house or a city, the mayor's office, but on the federal level, it is the white house. the white house can call together all of the relevant agencies and have them coordinate their leadership and activities. only the white house can bring in the private sector, retailers, restaurant chains, the me and others and have them
make commitments. earlier this week -- last week, secretary of agriculture ville sack with the secretary of commerce and the debt pretty secretary of hud visited a supermarket in inner-city philadelphia with support of the pennsylvania fresh food financing initiative. they are open or under development, good for health and good for economic development. both public and private sectors are important in deciding what and how much our children eat, whether we are active for sedentary, being active is easy or save, good food is convenient and affordable and whether our schools are healthy places for our children. my welcome to you includes a
charge that this meeting will give you the passion and urgency and confidence to join those that are speaking up, so too few become many, so the actions of the too week or too small grow strong and large and are fragmented and and coordinated efforts, cohesive and powerful movement. thank you. [applause] >> thank you for those very strategic comments. i think you are do personal recognition for your contributions to this, you are part of the green shoots of optimism and your work has been phenomenal. thank you. [applause] it is my pleasure to introduce a rare admiral stephen
galston who has served as acting surgeon general of the united states. as the nation's chief health educator he has provided americans with the best scientific information available on how to improve their health and reduce the risk of illness and injury. in addition he serves as operational commander of the commission corps of the united states public health service. prior to his appointment to acting surgeon general, rather admiral gallstone oversaw national and international programs in pharmaceutical regulation. reroutes admiral galston has helped senior level physicians at the environmental protection agency and the department of energy. he is the recipient of many
public health service awards, please welcome dr. galston. >> thank you for that kind introduction, thank you for your leadership of the chronic disease center. you have been a fantastic professional partner. [applause] you took the words out of my mouth. wanted to be sure we gave janet a round of applause before we got started on everything she did to bring this conference to fruition and the great progress we are making on this critical issue. a conference like this does not happen without a lot of people working together, partnerships to get the agenda and everyone into town. thank you for all of you who forked is a great day together. you would not be here today to appreciate the magnitude of the national health problem, if you
didn't already appreciate it, the talks you heard from dr. frieden and dr. marx reinforced the growing burden of obesity is causing us to shortchange our future, shortchange our future as a productive, healthy nation and also shortchanging our capacity to meet globally in the future. sadly, in spite of the enormous strength of our public health system in the united states, federal, state, local, public and private, there has been no match for the powerful trends and forces fueling the obesity academic. the toll of obesity is driving up health care costs and crippling the fabric of many communities around the country. as the acting surgeon general i have dedicated a large proportion of my time for the last two years to raising
awareness and prompting action at all levels of our society on the obesity epidemic. over the last year and a half i have traveled the nation, leaving behind a federal buildings and the politics of washington, visit communities that understand first and their challenges in addressing childhood obesity. i visited nearly 40 states to learn about opportunities and challengess, facilitate dialogue among state, local and other community leaders, and highlight the programs that are making a real difference. our healthy you for a future out reach activities mobilize communities to work together towards a common goal of helping youth stay and get healthy. i have met many of you in the audience. i see a lot of familiar faces around the country. it has been truly inspiring for me to lead round table discussions with government leaders, passionate community
activists, leaders in the business community, and parents, but most of all, it has been inspiring to participate in many events with children, schools, boys and girls clubs, events with children who are being empowered to make a difference in their lives and be part of a solution to childhood obesity. during these visits, i have done a fair amount of speaking but i have also done a lot of listening. it is an honor to help me open up this meeting today by sharing with you some of the common themes that i have heard from alaska to florida from california and maine and lots of places in between, in urban, suburban and rural settings. there are three main messages that i have taken back to washington from these visits. the first is that americans from all walks of life, community leaders, parents, corporate and
religious leaders, all of them are very worried that we have a severe problem with obesity in this country. we have been largely successful, i think, in our public health proselytizing here. most people i have met, don't need more proof that obesity is a problem. we have got them there, we have got them convince the. more on this in a minute, they want and expect national leadership from washington in helping forge solutions. i am glad this bridge from the previous two speakers. when they have the tools -- the question i am frequently asked when i open for questions and answers session the round the country is how did we get this
way? my response in the most general sense as you can imagine is there is not one cause, and the solution must involve -- was we have heard already, all the sectors in our society. what i have spoken about, crosscutting changes needed in national health, national food, transportation and the education policies and practices, the question is, that sounds really reasonable, what are you waiting for back in washington? why aren't you doing that already? why aren't you bringing these folks together? when i speak about the inside the beltway type of challenges of getting federal departments to work together on foreign policy that supports healthy eating, the people around the country said you are in washington, fix that. when people spoke about the difficulty of getting reimbursement for the care kids get in obesity clinics and i started talking about medicaid
and complex regulation, they kind of glazed over and said the same thing, you are in washington, why don't you just 6 that? when we talked about the alarming lack of sidewalks and playgrounds and newly constructed suburbs around the country and i visited some of them and responded about federal policies rooted in congressional language, it was the same thing. you are in washington, why don't you fix it? the people i spoke to around the country want policy change. they want leadership that understands the holistic nature of the solutions needed for obesity and they want action. but the strength of this country, and this is what has been deeply impressive to me, they are not waiting for washington, they are moving along and frequently you are walking along, those in the audience, organizations and schools, state and local governments, to implement changes now, changes that can make a real difference in this epidemic. i want to give you a few
examples of some of those changes that have been really impressive to me and traveled around. some grocery chains are taking bold steps to help shoppers navigate the aisles and fill their cards with healthy choices. supermarkets in new england, the guiding stars program is a three star system designed to simplify nutritious shopping. foods are labeled with 1, 2, or 3 stars corresponding to good, better and best levels of nutrition. results were seen in just one year after implementation. selection of whole milk with no stock dropped, fat free milk, 3 stars, increased, selection of breakfast cereals increased 3-1/2 times more than no star cereals. selection of fattier meats declined, starck chicken grew at 5%. this is hard data.
hanford's is a powerful model that shows when consumers are empowered with simple, easy to understand information at the point of purchase, they make better choices. it didn't take the regulatory process or a lawsuit to have the companies step up and do the right thing. another example is the faith based networks that exists all across this country and can also be powerful agents of change. in mississippi the united methodist church's wellness task force launched the amazing pace health promotion program. currently there are over 500 faith leaders who were amazing in mississippi, by wearing a pace the daughter and sending them the amazing pace database, a pacer travels along inspirational virtual journeys with measurable prevention goal. as a result, whole families and whole congregations are
integrating healthy habits into their everyday lives. corporations are also making a difference. ibm, through employee initiative incentives is helping its employees and their families live healthier lifestyles through its wellness for life program. many of you have heard about this. i am sure ibm has awarded more than 600,000 cash rebates by active participation in their preventive care, physical activity, nutrition, children's health and smoking cessation programs. they are using technology to share resources, track progress against personal goals and get financially rewarded at the same time. as you have heard of some of this already, individuals schools in some school districts all across america without a federal mandate are reducing student access to sweetened beverage class and increasing healthy choices in vending machines and cafeteria lines. some schools are combining
fitness with learning. novice middle school in miami, anybody here from florida? any florida people? they have treadmills, exercise bikes where students can watch pawed casts of math lessons while they exercise. it was an unbelievable sight to see young students lining always anxiously awaiting to their turn to use this fitness equipment. in an urban birmingham, alabama, joe's family farm work with area elementary school to get children excited about gardening, proper nutrition and health cooking. the pharma also provides food and vegetables to the schools through a farm to school program, something being done around the country. these examples show the power of what can be done when communities, corporations and individuals commit to better health for themselves, their families and their communities.
unfortunately, these are just examples and not the norm around the country. in each business i have made it a point to interact directly with kids to model healthy behaviors. this has taught me that anyone who can model healthy behaviors should, because we know and we have learned that this can make a difference to children. i would like to cross portland, ore. gardened in new hampshire, enjoy a playground time in mississippi, and challenge youngsters to dance revolution in several states, and if you possess any video recordings of me in these dance exploits, please destroy them. my travels, and hundreds of conversations with people all around the country, have reinforced that educating kids about healthy habits and providing opportunities for them to follow through is a winning combination. you are going to hear many
examples like this this week at this meeting. how are you going to take these great examples and move them into the next level of implementation? i look forward to hearing about many action oriented agendas coming out of this meeting. i want to leave you today with a sense of the optimism that i hope carries through the next few days. in my 23 year public health care rear, we have not had a president mention prevention as much as president obama. [applause] the american recovery and reinvestment act passed this year offers a powerful opportunity to take many of the lessons about preventive health so that we can implement them on a larger scale. i have been proud to play a role in the design of these efforts. the health care reform bills being considered will move
prevention smartly into the mainstream of our medical system in some game changing ways. we need to take advantage of these opportunities that may not come around again soon. as i finish up my tenure as acting surgeon general i have a strong conviction that curbing the of the city crisis and improving the health of americans is doable, and healthy future based on prevention is within our grasp. many of you in the room our national leaders, trendsetters, kiam commanders of the changes in this country that will be needed to reduce obesity as a nation. we stand to make and sustain progress because of commitments from people like you, you in this room who came to listen, came to learn and to share ideas and commitment about how to help in the future. i hope each one of you, full of inspiration at the end of this conference, will make the commitment to working even more
furiously towards change and the conditions that have brought this country and obesity epidemic that we simply must turn around. this conference offers tangible evidence, health policy leadership in this country, does get it, is organized around crosscutting solutions, and is finally talking about promoting federal policy changes that can make a big difference. i look forward again to hearing about the fruits of your meeting this week. thank you very much and good luck. [applause] >> thank you dr. galston. the contributions that you have made over the past couple years in this area are phenomenal. i have been party to those in terms of participating as part of the interagency committee that was formed and run by dr.
galston and it has made a big difference to us to have a location to come together and cooperate in ways that haven't been achieved before these meetings. i have often had the opportunity to see your schedule, and i would not even attempt it. it is quite phenomenal but he has literally pounded the pavement to give to the communities and get to the folks and really understand this problem in a real way and you have brought a tremendous amount to the work as a function of those efforts, thanks so much. and [applause] that was inspiring the very practical set of overviews of the problems we face.
we put into place to turn this around. we have just a couple minutes. i wonder as a function, a couple minutes of comments. feel free to add whatever comments you might have to the talks that you provided. especially dr. galston's speech highlighted the many activities, we are on the right track. will it be enough to achieve the end point that we are trying to achieve? or do we need to see change in terms of our commitment and engagement?
>> coming up on c-span2, treasury secretary timothy geithner and secretary of state hillary clinton speak at a dinner with chinese diplomats. live coverage of the senate as they continue work on the annual energy and water spending bill. >> on speak at -- c-span radio, the secretary of state, republican presidential nominee richard nixon and evangelist billy graham. saturday at 10:00 a.m. on c-span radio. >> how is c-span funded? >> public funded. >> donations, i have no idea. >> government. >> c-span gets its funding through taxes. >> federal funding. >> public funding. >> how is c-span funded? america's cable companies created c-span as a public service, a private business
initiative, no government mandate, no government money. >> treasury secretary timothy geithner spoke at a dinner in washington last night honoring a group of visiting chinese diplomats. we will also hear from secretary of state hillary clinton and state councilor of china. this is just over an hour. >> i am glad you are impressed by that. yous gracious and i am grateful to you. my compliments to our hosts, the business scalpel, it is a pleasure to be in a room with, i believe, all of the great statesmen of the business and financial community, and people who have spent so much of their lives building links between our two companies -- countries. i had the privilege of studying china early in life a long time ago when china was in the eve of what i believe has been one of the most remarkable
transformations in economic hvelopment we have seen in modern history. i think we should use that and take great confidence that when china sets out a path to reform they will have the capacity tov take great confidence that when china sets out a path to reform they will have the capacity to act on those basic objectives. henry kissinger gave him my first job, he did not pay me well but gave me the enormous privilege of a chance to wherewith him, and occasionally listen to me and has been enormously loyal and supportive to me ever since. i listened carefully to him every time i have the chance. secretary clinton and i spent a remarkable couple days. we understand that the world is ting to want to know -- they are going to watch what we do,
not just what we say. if we look at what china has accomplished in the economic field in the last we 6 months it ut remarkable. in the face of the worst, most challenging economic financial crisis the world has seen in generations, china and the wo differents countries, different traditions and different histories came together working with countries around the world and put in place a very powerful set of rograms to support demand -- repair the damage to our financial systems, and i believe the strength of those actions, the power of the signals sent by these two important countries coming together and making it clear that we would do what is necessary to bring the world back to a path of growth, was very important in helping sow the seeds for stabilization we
have seen and the improvement of financial markets that is now underway. the most important thing that we accomplished today, apart from reinforcing our basic commitment to build the strategic mutual trust that any good relationship depends on, is to set out these we to countries, to set out a path to a more balanced and sustainable global recovery in the future. global recovery in the future. we want to be careful as we emerge from this crisis, which we will, that we do not sew the seeds for future crises, that we put the economy on a foundation that will provide a credible path to more stable more that is going to require things in both our countries. in the united states, we have to go back to living within our means, we are going to have to make substantial steps to improving things that are central to our productivity and future, education and health care, energy efficiency, public infrastructure. china understands the basic pragmatic reality.
those changes in the united states have to be complemented by changes to run the world and china has laid out a remarkable set of reforms to move its economy on to a pass where future growth comes from consumption and services, domestic demand, and that basic reality, that basic strategy will be enormously important to both our countries and to the world economy as a whole. i have a great privilege of having as my counterpart the vice premier of china, wang qishan. i want to say a few things about him before he speaks to you. those of you who know him know that he is remarkably direct, he is a remarkably pragmatic person, he is intellectually challenging, engaging, funny, a deep sense of irony to use bob's
words. those of you who met him understand this. you just look at what he has been asked to to do for his country, he has been asked to take on some of the hardest problems that remarkable economy has faced. he is the preeminent troubleshooter, firefighter, problem solver, and he has done remarkably well in that context. he is the man they turn to in moments of opportunity in crisis, that makes for countries around the world a remarkably valuable counterpart. we made a very good start these past couple days. this relationship between the united states and china is in a very strong position. we have a very good basis of mutual understanding about what we face, the pressures we are undertaking, and we are trying to get the big strategic things
right at an early stage in this administration, early stage in this relationship and by focusing on the strategic questions, by recognizing our common stake in reform, by working closely with china to help build a more resilience international financial system we are going to have a better chance of getting the strategic things right and that will provide a better basis for dealing with a full range of problems we are going to face in the two countries. thank you very much. [applause] >> thank you for those great remarks and prioritizing the u.s./china relationship so early in this government, this administration's tenure and understanding the importance of our mutual economic future and as well said in china from crisis comes opportunity and your remarks, and on the need for change in both of these great nations, change in dealing with economic issues, change
when dealing with energy policy, climate change, health-care and many related issues in security. to permit me to speak on behalf of the dow chemical co. u.s./china business council, all the associations and organizations in this room as well as all the government and businesses that are represented here by their esteemed for leadership, this is the most important issue before both nations and couldn't be in better hands. timothy geithner denigrate the beginning to introduce the leader of china who is playing an instrumental role on the economic side of the strategic and economic dialogue which is of course the vice premier wang qishan. his resume speaks for itself. the only part of it that i want to dwell on, as timothy geithner said, this gentleman is beyond being a firefighter and problem solver, has a wicked sense of humor. we hope you will touch us with
all remarks you possibly can that deal with the gravity of the issues before us and enlighten us, mr. vice premier on how you see this great relationship moving forward. without further ado, ladies and gentlemen, please welcome the vice premier of china, wang qishan. a [applause] >> translator: secretary clinton will be joining us in a while. secretary timothy geithner,
madam hill, ladies and gentlemen, present here today, i am deeply honored to have this opportunity to meet with you tonight. mr. liveried has depressed me. a line of thinking, in his very words in uncertain world's, this world of uncertainty. that is a book that would have had a major influence on me and i agree with his points in that book, and i came to know mr. rubin. people sometimes say a famous teacher must have smart students. and i just came to know that
secretary timothy geithner with henry kissinger and mr. rubin, that is the kind of relationship between tutor and student that inspired me until i am thinking about teachers that i can name you are as great as they are and i found one. and this is when i was in northwest university in china, there was an old professor in that university. he was the very same in geology.
in the 1920s -- founded by the conversation by allied forces who invaded china once i came to study in the united states, stanford university and the university of chicago called these universities. ladies and gentlemen, you may not necessarily know this person i am going to talk about, i just know his english name. he is very great, outstanding scientist. i can tell that the structure and composition, there are five schools of theory.
the most popular school of these theories was advanced by the one that i mentioned. and he was initiator on the most popular, authoritative school on the structure of the shell of the earth. we were young and eager to learn from him and we asked him, how come you had these scientific findings which was very popular and widely accepted across the world? and he told us how. and what he said has had a major influence on me all the leaders. back at the time, was studying in the u.s. after studying
theology. i wanted to write a thesis. i got everything for inspiration, now everyone is traveling to the united states by airplane. if i took an airplane, maybe i would not have been able to -- we traveled to the united states by boat and it took us more than a month to travel to the united states. those who do not have the experience of traveling by boat, you might think it is going to be a great experience, but for us, it was quite boring. and every day, i was sitting on the deck. i was sitting on the deck
thinking about my sleep. i was thinking the about the knowledge i have acquired. and my ideas on the structure of the shell of the earth. everyday i was watching the waves, the tides in the oceans. and all of a sudden it came upon me that why the whales were not moving directly up and down. the waves were moving in curves. based on my knowledge of dynamics and a belated pherae i came to realize that everything is moving in the most efficient way.
movement construction theory. that inspired me and i thought of the wave of history. the historical process, also understand the waves of history are moving in a way of the ocean waves, the way that history -- they will fill or become losers. we should move in line with the direction of the wave of history. in my view, it was initiated, exactly in the direction of the historical wave. why has it been so hard?
because its power comes from the fact that the chinese people want peace and development, the chinese people want prosperity and cultural progress. actually, the whole world and people across the world all want these, peace, prosperity and cultural progress. statesmen, scholars. if there's a trend of the historical wave, they can succeed. we talked about the relationship.
china/u.s. relationship, the reason it has come so far today, because the trend on history, moves in historical way is. that serves the people. that is because both countries have come to appreciate that point. henry kissinger is with us tonight. dr. kissinger was one of the pioneers in normalizing the relationship between our two countries. and he was more lucky than most of the chinese people present here tonight because he had a
chance to meet premier joke, who we loved deeply. and he had the opportunity to me mr. dun chao he witnessed an experience, how great changes have taken place in china. so henry kissinger is an eyewitness of modern china. friends here tonight also witnessed, parts and sections of china opening up the process,
who was riding a bicycle in beijing in 1981. and including his father. on the internet, people sometimes talk about my relationships, sometimes they think i am one of the uncles of secretary timothy geithner. because his father -- was the representative of the ford foundation in the 1940s -- 80s. i was told with his father to apply for funding support from the ford foundation to support my research programs. so we had a working relationship people in chinese say, if you
my professors. and how he was unlike and in his research and his inspiration has inspired me. i associate that inspiration with politics, history, and the history of chinese relations. said that in doing so, i offer the question raised by mr. limit. the trend in the chinese relationship is decided by good people. it is decided by the common interests. in these countries, can only follow these trends, it must
follow this trend. i almost forgot. it is not for free. there is no free dinner in the world. after talking about this, i almost forgot i have another point to talk about which is very simple. with efforts of secretary clinton, the u.s. has accomplished its task of getting enough funding to have -- the groundbreaking ceremony has been established. one person here has worked hard for that. some of you provided financial support and very good advice.
next time -- i was talking about olympic games. on the organizing committee of the shanghai world experts. on behalf of the organizing committee, i thank all of you for your care and support for the shanghai world and will. meanwhile, i extend congratulations to all of you, i welcome you to shanghai, thank
you. [applause] >> if i could ask you to take your seats, we're going to start our post dinner program. i guarantee you the faster you sit down the list of me you will hear. if you could, ladies and gentlemen, please join me in welcoming back to the podium carla hill, the chairwoman of the national committee on u.s./china relations. thank you. [applause] >> thank you, john. you have done a good job and you have fed us well and good evening once again. it is my great pleasure to have the opportunity to introduce our 67 secretary of state, hillary clinton, who took her oath of office on jan. 20 first, just one day after president obama's inauguration. a graduate of wellesley college and a graduate of yale law
school, the secretary earned high accolades for her work while she was in the private sector. as a lawyer, a teacher, an organizer of private organizations and the author of 2 best sellers and in the course of her career she has achieved an incredible number of firsts including as first lady of arkansas, first lady of the united states, the first first woman to run for the u.s. senate and the first woman to be elected statewide in new york. her experience gained in the senate from her service on a variety of committees dealing with on services, budget, health, and education, and the environment, coupled with extensive travel, have prepared
her well for her current position. the secretary has been quoted as saying our relationship with china will be the most important bilateral relationship in the world in this century. and she has demonstrated her interest in building that relationship by traveling to china on her first overseas trip as secretary this past february. it was her suggestion to elevate the u.s. participation in the strategic portion of the u.s./china dialogue to cabinet rank, and she has urged that we demonstrate that in her words, the united states and china can productively work together not only where we have bilateral concerns, but to show leadership to the rest of the world.
with the g 20, the copenhagen meeting the approaching very fast, our two nations have a chance to do just that. madam secretary, you have a room full of people who wish you success in all of your endeavors and we look forward to your remarks. [applause] >> thank you so much, thanks for your leadership in this undertaking as well as so much else. it is wonderful to be here at the end of two busy and productive days of the strategic and economic dialogue.
timothy geithner and i were privileged to cote lead this effort and we were especially pleased that vice premier wang and state councilor dai where our counterparts. we believe that these very productive conversations have helped to lay the foundation for what president obama and president hu jintao called the comprehensive china/u.s. relationship the 20th-century. -- twenty-first century. we are listing the full range of talent within our government to tackle problems that spill over not just borders and oceans but also traditional bureaucratic boundaries which are sometimes the hardest to overcome, from climate change to trade and investment to poverty and disease.
just as no nation today can solve the challenges we face alone, neither can government work in isolation. the issues are too very and complex for that. so engaging the expertise, experience and energy of those outside government, including the private sector and all of you here tonight, is vital to our future progress. i also am delighted that we are going to have, very soon, a new ambassador from the united states to china, who will soon be confirmed ambassador huntersman, looking forward to working not only on behalf of our nation's policies, but willie representing the american people to the chinese people. we want the entrepreneurs and innovators in both of our
countries to know that we are behind their problems. we want the front lines of innovation to know that we are looking to support their efforts, because we think public/private partnerships are a centerpiece of the important work that we are doing to build understanding and create new avenues of cooperation. i understand vice premier wang said a few words to you about the shanghai expo. i want to reinforce his message. the theme for the expo, a better city, better life, will present a vision of a sustainable, healthy, prosperous world in the 20 first century. it is anticipated that more than seventy million people will
visit, and more than 190 nations will participate. six months ago it wasn't at all clear that the united states would be one of those 190 nations. , but fakes to a number of view, we are on track to be able to do so and i salute vice premier wang for his leadership. he was, as some of the know, the chair for the committee of the beijing olympics. that is any indication of his organizational acuity, i think we can look forward to a very successful shanghai expo. and the u.s. national civilian will be informative, educational and interactive, showcasing american ingenuity, looking at how we can address together global challenges like climate change and clean energy, sustainable agriculture, mass-transit, health and economic development. we are delighted that the number
of leading american companies such as ge and pepsi, marriott, corning and others, have signed on to be part of putting together this visionary pavilion that will showcase much of what is best about our country. there is actually a model of the pavilion's somewhere around here that i urge you to take a look at. this is shameless, i know, but that is part of the job. we formally signed participation contract. we have a you as commissioner general, jose valerie all. ambassador bagley is here. we have raised half the funds needed to begin construction. i have told the vice premier and state counselor that if
necessary i will personally build it in order to get it ready by the may opening. commerce secretary gary lauck traveled to shanghai for the pavilion's groundbreaking ceremony. so we are on to ask. ambassador bagley and chris balder sen -- balderson are ready to answer questions. i mention this at some length because we feel very strongly that this partnership between china and the united states in the 20th-century needs to be manifest in visible ways. secretary timothy geithner, at the conclusion of his discussions with the vice premier, announced some very positive findings and
commitments moving forward on our economic recovery efforts. state councilor dai and i discuss literally every part of the world and have a very good understanding of how we can continue to work together. but this is all about the future. i told this story before but i want to end before i have a great privilege of introducing the next speaker. state terms of their dai and i had a wonderful, relaxing, social dinner sunday night at the blair house where we spent time talking about everything and getting to know each other better. wasn't about the business of two great countries trying to determine the best way for would for our people and the world, but it touched on what is important. is that counselor dai had just had a new grandson and he told me with
that wonderful smile that lights up his face-- and we were thinking about the significance of what we were about to embark on for the last two days. i suggested that before every meeting, we bring pictures of our children and our grandchildren, because truly that is what this work is all about. that is what should guide us and inspire us and jason nuss with respect to the decisions we make, so that is going to certainly be a principal of andicipation commitment that counciller dai and i intend to pursue because this is part of a new beginning. it is a consume -- culmination that began. when dr. kissinger was instrumental in opening the door to the possibility